VP, Member & Provider Support Center Services

JOB DESCRIPTION Job Summary

Provides executive level strategy and leadership to team responsible for member and provider services support center operations. Develops and drives strategies to optimize operational excellence, support growth and increase member and provider satisfaction. Ensures functional operations, contractual compliance, and alignment with member satisfaction, retention, quality, and financial goals.

Essential Job Duties

• Supports executive strategy development, vision and direction for the member and provider support center services function. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
  • Demonstrates accountability for all member and provider support center services activities including workforce management, reporting, quality assurance, business solutions, vendor performance and telephony across the Medicaid, Medicare and Marketplace lines of business.
  • Develops and drives strategies that support growth and increase member and provider satisfaction.
  • Develops and maintains strong relationships with internal and external stakeholders to provide optimal shared services delivery throughout the enterprise.
  • Ensures seamless integration of newly acquired employees, including scope of work and structure.
  • Identifies projects/initiatives that reduce administrative costs and introduce innovative solutions.
  •Convenes work groups, develops implementation plans with identified tasks, timelines and assigned parties, and executes and measures success.
  • Leads direct Molina staff, and oversees vendors and performance accountability for services rendered to support center - enabling the organization to produce operational results at the lowest possible cost, the most consistent and compliant service levels and the highest level of quality for all lines of business.
  • Ensures all state, federal and Molina regulations, policies/procedures and standard operating procedures (SOPs) are implemented and followed on a consistent basis to ensure the highest compliance possible within support center function.
  • Sets and manages overall costs to meet/exceed annual budgets set for each or all assigned areas, and finds ways to improve productivity and automation wherever possible to reduce unit costs and overall general and administrative (G&A) for the organization.
  • Designs and implements systematic approaches to improve member and provider experiences through increased operational efficiency and effectiveness.
  • Reports potential liabilities for financial tracking and accruals to senior leadership.
  • Hires, trains, develops and manages team; demonstrates accountability for team performance and achievement of department-specific goals.
  • Models dynamic leadership; develops team to focus on delivering great health care/customer service to underserved populations.

Required Qualifications

• At least 12 years of health care operations and/or contact/call center experience, including experience managing large matrixed teams, or equivalent combination of relevant education and experience.
  • At least 7 years of management/leadership experience.
  • Experience leading operations for multiple markets and product lines.
  • Data analytics, customer experience, workforce management, and quality metrics experience supporting operations and business/innovative solutions.
  • Experience developing and managing department budget within prescribed parameters.
  • Experience with account management responsibilities with senior level leadership.
  • Understanding of Medicare, Medicaid, and Marketplace plans.

• Experience with Genesys/Salesforce.

• Ability to influence and drive change among peers and others within the organization.
  • Skill to envision, craft proposals, obtain consensus around approving and implementing future state processes and systems needed to support strategic direction set by organization.
  • Demonstrated adaptability and flexibility to change, and to new ideas and approaches.
  • Strong organizational and time management skills; ability to manage simultaneous projects and tasks to meet internal deadlines.
  • Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
  • Ability to work cross-collaboratively across a highly matrixed organization and establish and maintain effective relationships with internal and external stakeholders.
  • Excellent verbal and written communication skills.
  • Microsoft Office suite (including Excel), and applicable software programs proficiency.

Preferred Qualifications

• Experience implementing process improvements in a matrixed environment.

• Managed care experience.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Originally posted on Himalayas